Radiotherapy Department, centre Jean-Perrin, Clermont-Ferrand, France.
Radiotherapy Department, centre hospitalier universitaire Lyon Sud, Pierre-Bénite, France.
Cancer Radiother. 2024 Nov;28(6-7):580-585. doi: 10.1016/j.canrad.2024.07.011. Epub 2024 Oct 10.
The modalities of management by reirradiation for recurrence or a second localization of head and neck squamous cell carcinoma (HNSCC) in previously irradiated terrain is challenging due to the great heterogeneity of data in the literature, mainly retrospective data reporting non-negligible risks of serious late toxicity events. With the recent development of more precise and conformal radiotherapy techniques such as intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), stereotactic radiotherapy (SBRT), the benefit-to-risk ratio of reirradiation has evolved in recent years with encouraging results, but patient selection is crucial. The aim of this review is to discuss the role of HNSCC reirradiation in terms of patient selection and external photon radiotherapy techniques for definitive tumor reirradiation and postoperative reirradiation.
对于在既往放疗区域复发或出现第二个局灶的头颈部鳞状细胞癌（HNSCC），再次放疗的管理方式颇具挑战性，这是因为文献中的数据异质性很大，主要是回顾性数据报告了严重迟发性毒性事件的不可忽视风险。随着调强放疗（IMRT）、容积调强弧形治疗（VMAT）、立体定向放疗（SBRT）等更精确、适形放疗技术的发展，近年来再次放疗的获益-风险比发生了变化，结果令人鼓舞，但患者选择至关重要。本文旨在讨论 HNSCC 再次放疗的作用，包括明确肿瘤再次放疗和术后再次放疗时的患者选择和外照射光子放疗技术。
